NHS plans to scrap prescriptions for common health problems have been criticised for hitting poorer families.
Prescriptions for conditions including diarrhoea, thrush, acne and acute pain are among those up for review.
NHS England said 18 treatments – such as homeopathy and some types of pain relief – cost the taxpayer £141m a year and generally should not be prescribed.
But the Royal Pharmaceutical Society (RPS) argues that low earners will be “disproportionately affected”.
RPS England board chairwoman Sandra Gidley said: “They should not be denied treatment because of an inability to pay.
“Longer term costs to the taxpayer of increased ill-health, subsequent GP consultations or visits to A&E must also be taken into account as a result of medicines not having been prescribed.”
NHS England launched a three-month consultation on the plans on Friday, arguing that millions could be saved by cutting out prescriptions for “ineffective, over-priced and low value treatments”.
The consultation also proposes action to limit prescribing of products for minor self-limiting conditions, including cough mixtures, eye drops and sun cream lotions, costing £50m to £100m a year.
NHS England said it was also supportive of restricting the availability of gluten-free foods on prescription, which costs £26m a year.
‘Low value’ medicines on the list and their annual cost to the NHS:
- £34.8m on Liothyronine, used for underactive thyroid
- £19.8m on the anti-depressant Trimipramine
- £19.3m on Lidocaine plasters for treating nerve-related pain
- £11.5m on Tadalafil Once Daily, similar to Viagra
- £10.9m on Fentanyl immediate release, used to treat breakthrough pain in palliative care
- £9m on the painkiller Co-proxamol
- £7.8m on Doxazosin Modified Release (MR), a drug for hypertension
- £6.3m on omega-3 fatty acid compounds
- £5m on Oxycodone and Naloxone, used to treat severe pain
- £4.5m on travel vaccines
- £4.3m on muscle pain relieving rubs and ointments
- £2.7m on the anti-depressant Dosulepin (formerly dothiepin)
- £2m on Paracetamol and Tramadol Combination product
- £1.5m on Lutein and antioxidants (e.g. vitamin A, C, E and zinc) supplements
- £0.5m on Perindopril Arginine an ACE inhibitor used in heart failure, hypertension, diabetic nephropathy and prophylaxis of cardiovascular events
- £0.4m on Glucosamine and Chondroiton, nutrients taken to improve pain associated with osteoarthritis
- £100,009 on herbal medicines
- £92,412 on homeopathy items
Simon Stevens, NHS England chief executive, said he was determined to “root out” waste and inefficiency.
He added: “The public rightly expects that the NHS will use every pound wisely, and today we’re taking practical action to free up funding to better spend on modern drugs and treatments.”
He described homeopathy as “at best a placebo and a misuse of scarce NHS funds”.
The RPS agreed that removing homeopathy “which has no scientific or pharmacological basis from NHS supply is long overdue”.
It also welcomed the removal of ineffective and unsafe medicines.
However, it said it had “serious concerns” over plans to restrict effective medicines for common conditions, such as head lice or athlete’s foot.
The British Medical Association (BMA) also said it could not support the plans to scrap prescriptions for effective medicines.
Dr Andrew Green, BMA prescribing subcommittee chair, said the move was likely to increase health inequalities and expose GPs to the potential for complaints.
He added: “We are particularly concerned about the harm this may cause for those already most disadvantaged in society, and cannot have GPs applying arbitrary means-tests or judgements as to the likelihood of patients not taking recommended medicines on the basis of cost.”